HomeMy WebLinkAboutGrant Related - BOCCGRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12:00pm on Thursday)
REQUESTING DEPARTMENT: BOCC
REQUEST SUBMITTED BY: Karrl@ Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: Kal'1'12 Stockton
CONFIDENTIAL INFORMATION: DYES ® NO
DATE: 9/30/2025
PHONE:2g37
TYPE(S) 0
SUBMITTED:
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&-11=*19A!j e s •TV - • r&at
Reimbursement request from McKay Healthcare on the Strategic Infrastructure Program (SIP)
Project No. 2023-01, Phase 1 Architecture and Engineering Site Plan in the amount of
$13)646.35.
If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A
If necessary, was this document reviewed by legal? ❑ YES ❑ NO W N/A
DATE OF ACTION: !% 'Z- ,r
z- DEFERRED OR CONTINUED TO-
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
WITHDRAWN -
4/23/24
PROJECT CERTIFICATION
This form must be signed and returned, with an invoice, for the approved funding,
before reimbursement can be approved by Grant County.
SIP Project Proposal Number:
SIP Funding Recipient
SIP Project Description
SIP2023-01
McKay Hospital & Rehab
Phase I Architecture and Engineering Site Pla*n
I the undersigned, do hereby certify under penalty of perjury, that the materials have
.1
been ftw-m'shed, the services rendered, and/or the labor performed as described in the
project proposal for the above -referenced SIP Project and that I am authorized to
authenticate and certify to this claim. I also certify that this claim of $13,.6�6.35 is just
Is
and due and is an unpaid obligation against Grant County.
Further, according to the SIP Project Funding Policies, I attest that' at the next audit of my
entity, this project shall be called to the attention of the Washington State Auditor's
Office and an emphasis audit Will be requested to assure that these -funds were expended
toward the project and according to the intent of the proposal.
"IA.A - - - ------- -------
Signature
Audra Gutierrez -- -- -----
Printed Name
157
Date Sig�ed
Adm or/ . e ntedt.
Title
nt
Printed Title
Completed, signed original certification and invoice are to be mailed to:
Adni'm"Iestrative Services Coordinator, PO Box 37, Ephrata, WA 98823
Reimbursement # 29 in the amount of 113,646,35.
ATTACHMENT 4
g
11AMLLER
275 Fifth Street, Suite 100
////R
Bremerton, WA 98337
(360) 377-8773
i
t3,(.yto.35 SIP 2-OZ. 3 AP01 TC AhLL
1915 E1�iTEREYD
RECEIVEO AEG 13 AUG 13 2025
BY:
Public Hospital District No. 4 of Grant County, Washington Invoice number 2023052.00-022
P.O. Box 819 Date 07/15/2026
Soap Lake, WA 98851
Project 2023052.00 McKay Healthcare SNF Pre -
Design - Master Planning
Professional services through 06/30/2025
Invoice Summary
Contract
Total
Prior
Contract
Current
Description
Amount
Billed
Billed
Remaining
Billed
Scope 1A - Conceptual Design
100,184.00
100,184.00
100,184.00
0.00
0.00
Scope 1A - Schematic Design (Reduced by C07)
66,840.00
66,840.00
66,840.00
0.00
0.00
Scope 113.1 - Site Plan Design (Reduced by
77,200.00
77,200.00
73,350.00
0.00
31850.00SIP2023-01
Change Carder 04)
Change Order 02 - Scope 1 B.2 - Zoning Approval
13,728.00
13,727.90
13,727.90
0.10
0.00
(Reduced by C07)
Change Girder 03 - Phase 1 Schematic Design
174,500.00
174,500.00
174,500.00
0.00
0.00
Change Carder 03 - Phase 1 Design Development
213,000.00
213,000.00
146,522.00
0.00
66,478.00SIP2024-05
Change Order 04 - Phase 2 Master Planning
51,940.00
28,750.40
21,261.25
230189.60
71489.15SIP2023-01
Change Carder 05 - Phase 1 CD
Change Order 05 - Phase 1 CD - RFM
166,790.00
20,065.00
20,065.00
146,725.00
0.00
Change Order 05 - Phase 1 CD - Civil
440800.00
0.00
0.00
44,800.00
0.00
Change Order 05 - Phase 1 CD - Landscape
28,560.00
0.00
0.00
28,560.00
0.00
Change Order 05 - Phase 1 CD - Structural
34,160.00
0.00
0.00
34,160.00
0.00
Change Order 05 - Phase 1 CD - MEP
72,240.00
0.00
0.00
72,240.00
0.00
Change Carder 05 - Phase 1 CD - Specs
6,750.00
0.00
0.00
6,750.00
0.00
Subtotal
353,300.00
20,065.00
20,065.00
333,235.00
0.00
Change Girder 06 - Phase 1 Food Service DD - CD
34,496.00
2,307.20
0.00
ft-
2,307.20SIP2023-01
Reimbursable Expenses
41925.79
4,925.79
4,925.79
7,3�`8.80
0.00
0.00
Total 1,090,113,79 701,500.29 621,375.94 388,613.50 80,124.35
Invoice total 809124.35
Aging Summary
Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120
2023052.00-022 07/15/2025 80,124.35 80,124.35
Total 80,124.35 80,124.35 0.00 0.00 0.00 0.00
For any questions regarding this invoice please contact Jilt Wolfard at (360) 377-8773 or jwolifard a@rfmarch. com
Public Hospital District No. 4 of Grant County, Invoice number 2023052.00-022 Invoice date 07/15/2025
Washington
McKAY HEALTHCARE
586 RiceFergusMiller
oa/vowngs 9.S3RP
----
Invoice Number
Invoice Date
..
Description
....
Gross Amount
Discount Taken
Net Amount Pa
2023052.00-022
07/15/2025
Admin - PS - SIP
$80,124.35
$805124.351
$0.00
$0.00
,124id
$80.35
801" 1 24*35
--------------
rt
IVICKAY HEALTHCARE
127 SECOND AVE SW - PO BOX 819
SOAP LAKE, WA 98851
(509)246-1111
PAY TO THE
ORDER OF
MEMO
US BANK 6041 095369
96.651/1232
08/13/2025
$80,124.35